Objective To examine childhood perfectionism in anorexia nervosa (AN) restricting (RAN), purging (PAN), and binge eating with or without purging (BAN) subtypes. Method The EATATE, a retrospective assessment of childhood perfectionism, and the Eating Disorder Inventory (EDI-2) were administered to 728 AN participants. Results EATATE responses revealed General Childhood Perfectionism, 22.3% of 333 with RAN, 29.2% of 220 with PAN, and 24.8% of 116 with BAN; School Work Perfectionism, 31.2% with RAN, 30.4% with PAN, and 24.8% with BAN; Childhood Order and Symmetry, 18.7% with RAN, 21.7% with PAN, and 17.8% with BAN; and Global Childhood Rigidity, 42.6% with RAN, 48.3% with PAN and 48.1% with BAN. Perfectionism preceded the onset of AN in all subtypes. Significant associations between EDI-2 Drive for Thinness and Body Dissatisfaction were present with four EATATE subscales. Discussion Global Childhood Rigidity was the predominate feature that preceded all AN subtypes. This may be a risk factor for AN.

Objective The YBC-EDS is a semi-structured interview assessing core preoccupations and rituals related to eating disorders. Method We developed and conducted an examination of the reliability and validity of a self-report questionnaire (SRQ) version of the YBC-EDS. Convergent validity of YBC-EDS-SRQ with the YBC-EDS was examined for 112 eating disordered patients. Results All subscales and total scores were significantly intercorrelated. Thirty-one additional patients completed YBC-EDS-SRQ at admission and again one week later. All correlations revealed significant test-retest reliability. Discriminant validity of the SRQ was evaluated for a smaller subset of participants who completed the Beck Depression Inventory (BDI) and State Trait Anxiety Inventory (STAI). There were no significant correlations between various symptom dimensions of the YBC-EDS-SRQ and the BDI and STAI. Discussion Taken together, these findings indicate that the self-report form of the YBC-EDS is both valid and reliable. The SRQ can serve as a useful and efficient assessment of eating disorder patients for clinicians and researchers.

Highlights• A computer program measured expected anxiety from foods in adolescents• Expected anxiety was larger for those with anorexia nervosa (AN) than controls.• Maximum tolerated portion was smaller for those with AN compared to controls.• Expected anxiety and maximum tolerated portion were inversely correlated.• Expected anxiety was predicted from severity of illness in adolescents with AN. Therefore, we adapted a computer program that was previously developed to measure 4 the satiating effects of foods in order to explore the potential of food to induce anxiety 5 and fear of eating in adolescent girls. Twenty four adolescents (AN) and ten healthy 6 controls without eating disorders rated pictures of different types of foods in varying 7 sized portions as too large or too small and rated the expected anxiety of five different 8 portions (20-320 kcal). Two low energy dense (potatoes and rice) and two high energy 9 dense (pizza and M&Ms) foods were used. The regression coefficient of line lengths (0 10 to 100 mm) marked from "No anxiety" to "this would give me a panic attack", regressed 11 from portions shown, was the measure of "expected anxiety" for a given food. The 12 maximum tolerated portion size [kcal] (MTPS), computed by method of constant 13 stimulus from portions shown, was significantly smaller, whereas the expected anxiety 14 response was greater, for all foods, for patients compared to controls. For both groups, 15 expected anxiety responses were steeper, and maximum tolerated portion sizes were 16 larger, for low, than high, energy dense foods. Both maximum tolerated portion size and 17 expected anxiety response were significantly predicted by severity of illness for the 18 patients. Those who had larger maximum tolerated portion sizes had smaller anticipated 19 anxiety to increasing portion sizes. Visual size had a greater influence than energy 20 content for these responses. This method could be used to quantify the anxiety inducing 21

Enhanced threat processing has been associated with elevated anxiety in adults, but less is known about how threat processing influences the developmental trajectory of anxiety in children. We used the N170 to measure threat (angry faces) processing in relation to child anxiety over a two-year period. Participants were 27 typically-developing five-to seven-year-olds (13 females). Higher anxiety when children were aged five to seven was associated with higher anxiety two years later, but only for children showing larger N170 amplitudes to angry versus happy faces. The N170 captures individual differences in threat processing that may characterize children at enhanced risk for anxiety.

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